“So I suppose the bit on time out didn’t help me as much because, I don’t know, I don’t really believe in time out. Um, ok, they can have time away to calm down, but I think some people might take it a bit too far” (Maria - C7).
The previous chapter indicated that there are numerous dynamics to parenting that are important, which can only serve to complicate the task for parents, and parent training programmes have helped some families. While there are useful principles in conventional behavioural parent training programmes, on their own they fail to meet the needs of many families. This chapter will discuss other elements that parents need when raising young children, which include: mindfulness and acceptance of the parent and the child as unique individuals in the relationship; appropriately managing emotions; understanding developmental stages; and
understanding the effect of parental attributions of child misbehaviour. While there have been attempts to include these in parent training programmes, it has not been in a synthesised manner and this piecemeal approach has failed to adequately deal with the multiple dimensions and relationship factors between the parent and the child (Granic, 2000).
The example from Maria (above) indicates her unease with using behavioural skills and was a feeling echoed by other parents in the current study. The previous discussion indicated that conventional behaviour therapy has focused on contingency management, such as reinforcement, planned ignoring, and time-out, but there is other research that emphasises contextual factors. It will now be demonstrated that while mindfulness and acceptance are increasingly being used in conjunction with numerous psychological interventions, behavioural parent training has failed to adopt them.
Mindfulness and Acceptance
Defining Mindfulness
To be mindfully aware of one’s surroundings and interactions with others requires more attention than people generally give to them. It will be illustrated that mindfulness has been a part of the Buddhist tradition for a long time, and in recent
times it has increasingly being incorporated into interventions for psychology and medicine where it has showed promising results, including for families. But one limitation is that teaching mindfulness is a lengthy process and requires more time and focus than many interventions could allow. Other treatments have incorporated aspects of it within a broader framework and this is also what is needed in parent training.
Mindfulness involves becoming more aware of one’s surroundings and is often taught through an assortment of meditation exercises. A working definition of mindfulness is: “the awareness that emerges through paying attention on purpose, in the present moment, and nonjudgmentally to the unfolding of experience moment by moment” (Kabat-Zinn, 2003, p. 145). Traditionally, mindfulness is a core practice in Buddhism but it has increasingly been adopted in psychological and medical settings without the religious implications. Langer (1997) indicates that people often report that a job or the work that they are doing is boring. However, Langer proposes that with mindful engagement (i.e., paying more attention to the details and becoming more involved in the activity) the task will appear more attractive and enjoyable for people.
A number of studies have demonstrated that practising mindfulness lead to improvements for participants: Mindfulness-based stress reduction (MBSR) has especially helped people with chronic pain to better manage their pain (Kabat-Zinn, 2003; Siegel, 2005); Mindfulness-Based Cognitive Therapy emphasises focusing not on the content of thoughts, but instead on the changing awareness of the relationship of thoughts to feelings and bodily sensations, and has helped reduce relapse in recurrent major depression (Segal, Teasdale, & Williams, 2004); when caregivers were trained in mindfulness their charges (individuals with profound multiple disabilities) displayed increased levels of happiness compared to individuals with control caregivers (Singh et al., 2004); and there was an increase in the reduction of aggressive behaviour in adults with developmental disabilities when their home group staff members completed mindfulness training and behavioural training compared to staff that only completed behavioural training (Singh, Lancioni, Winton, Curtis et al., 2006). One review of mindfulness-based interventions found that these might be helpful in the treatment of several disorders (Baer, 2003).
Furthermore, Singh and his colleagues have demonstrated positive results for parents and children after mindfulness training. They taught mindfulness skills to
three parents of children with autism and results indicated that there was a reduction in children’s aggression, self-injury, and non-compliance, as well as an increase in mother’s satisfaction with their interactions with their children and parenting skills (Singh, Lancioni, Winton, Fisher et al., 2006). In a replication and extension of this study with four children, again they reported a reduction in child aggression and increased maternal satisfaction with parenting. In addition, they found increased child social skills, decreased negative social interactions with siblings, and lowered parental stress (Singh et al., 2007).
Incorporating Mindfulness within Therapy
However, teaching the techniques and principles of mindfulness can be quite lengthy and this may require more time than is available in many therapeutic
settings. In addition, some advocates of mindfulness suggest that in order for the clinician to properly deliver the intervention they must practise mindfulness in their own life (Kabat-Zinn, 2003; Linehan, 1993), but this is not always probable. Over time it has developed that some interventions have adopted the principles of
mindfulness and incorporated them into a broader integrative framework. One such example is DBT for people with Personality Disorder (Linehan, 1993), which was discussed earlier so will not be mentioned in detail here. Suffice it to say that in DBT participants are encouraged to practice mindfulness exercises regularly and the central dialectic is the relationship between acceptance and change.
Another intervention that utilises mindfulness techniques and principles is Acceptance and Commitment Therapy (ACT). There is a so-called “third wave” of behavioural and cognitive therapies, of which ACT is a part, which emphasises contextual and experiential change strategies (Hayes & Wilson, 2003; Twohig, Pierson, & Hayes, 2007). This does not mean that they have discarded educational or direct change strategies but now focus on wider concepts such as mindfulness, relationships, values and emotional processing (Hayes, Luoma, Bond, Masuda, & Lillis, 2006). ACT uses acceptance and mindfulness strategies alongside
commitment and behaviour strategies, with the overall aim to produce more
psychological flexibility. Clients are encouraged to dispose of psychologically rigid self perceptions, as these can trap them into fixed patterns of behaviour, despite their belief that these patterns provide a small degree of temporary relief. Rather than
trying to avoid pain or suffering and seek only pleasantness, ACT focuses on
accepting that pleasantness and suffering are both normal parts of life (Hayes, 2004). ACT is a clinical approach that focuses on processes by using multiple
techniques. There are six core processes which are grouped under two main types: commitment and behaviour change processes (which include - contact with the present moment, values, and committed action); and mindfulness and acceptance processes (which include – acceptance, defusion, and self as context) (Hayes, 2004; Hayes et al., 2006; Wilson & Murrell, 2004). ACT has shown promising
correlational results across a range of problems but, since it is a relatively new therapy, there are not enough well-controlled studies to indicate that it is more efficacious than other active treatments (Hayes et al., 2006). What ACT does offer is an over arching process by which therapy can be conducted and it is at this level that ACT offers valuable information to parent training.
The principle of acceptance that is prevalent in ACT offers an important focus for the parent-child relationship too, since both the parent and the child, have unique needs that must be met for a healthy relationship. In addition, there are multiple dimensions across which this principle applies and a discussion of this will now continue.
It is imperative that behavioural parent training programmes address the dynamic relationship between the parent and the child. One parent training
programme that has attempted to include behavioural techniques and principles with relationship issues is Parent-Child Interaction Theory (PCIT) (Brinkmeyer & Eyberg, 2003). The treatment is conducted with individual families, involving both the
parents and the child, while emphasizing the need to first, have child-directed interactions such as praise, reflecting the child’s talk, imitating play and describing the child’s behaviour, which is then followed by parent-directed interactions. This approach aims to actively coach the parent in relationship and behavioural change skills.
Behavioural programmes are incomplete since they do not have a strong emphasis on the parent-child relationship and they offer little, if any, focus on dealing with the emotions that are very prevalent in the parent-child relationship. PCIT does include this aspect, however, there are other dimensions that PCIT fails to include (such as development and attributions) and these will be described later. The next section will investigate the importance of appropriately dealing with emotions
in the parent-child relationship. Research will be presented outlining the benefits of emotion coaching for the parent and the child and this needs to be an integral part of a parent training programme.
Managing Emotions in the Parent-Child Relationship
“We’ve been struggling a lot with anger in our house. Larry, our 3- year-old has got, seems to have had quite a short temper and I’ve had a short temper since our baby was born 9 months ago. Before that it was never really an issue. So it was really good to talk about anger and find out how other parents enforce the boundaries with their children aside from using time outs” (Andrea - A4).Parenting can be stressful and demanding for anyone and even more so when a child is displaying disruptive behaviour. Parents report that before they deal with the misbehaviour of their children they must first deal with the emotions that quickly well up for them, for example, in the Evans, Yamaguchi, Raskauskas, and Harvey (2007) study parents reported that they would first need to calm down and deal with their anger before they could reasonably plan a response to their child’s
misbehaviour. Therefore, before being able to implement behavioural skills parents must first deal with their own emotions that are related to their child’s behaviour. These emotions can be positive or they can be negative but there is one thing that parents often report, and that is that their emotions are very intense when they are dealing with their children. In fact, many parents are surprised with the intensity of their emotions.
Heightened Emotions in the Parent-Child Relationship
Feelings often experienced by parents, such as frustration, anger,disappointment, and embarrassment, well up quickly and, if not attended to, affect the relationship between the children and the adult. This was indicated in a study when, compared to emotionally-neutral mothers, angry mothers were more likely to expect their children to act negatively and judged children’s current problems as more serious (Dix, Reinhold, & Zambarano, 1990). Another study compared parents at high risk of child physical abuse to low risk parents, which found that high risk parents reported higher levels of hostile feelings after they had watched a video of a crying infant. Moreover, not only were increases in self-reported feelings of hostility reported, but hostile priming was modestly related to excessive force in a hand grip
exercise for high risk parents (Crouch, Skowronski, Milner, Harris, 2008). This could be an indication of negative behavioural implications when parents are experiencing heightened emotions, which could be detrimental to the parent-child relationship.
Parents might also have another unhelpful behavioural response to high negative emotions by using harsh discipline strategies. There is an ongoing research demonstrating an association between harsh physical discipline and child aggression (Deater-Deckard & Dodge, 1997), and one study revealed that harsh parenting had both a direct and an indirect effect on child aggression, mediated by child emotion regulation (Chang, Schwartz, Dodge, & McBride-Chang, 2003). This last study found that harsh parenting could be viewed not only as a form of behaviour
modelling but also as a form of affect communication. Therefore, the effect on the children is both direct – through behaviour that the parents are modelling, and indirect - through emotion dysregulation. These parental responses need to be understood within the context that strong negative emotions are common in
parenting young children. This was demonstrated in a study, which showed that 83% of parents who had children aged 24-36 months reported one or more episodes of frustration everyday (Wissow, 2002).
“I get really frazzled because I’m up and down and constantly intervening when he’s fighting with children that I’ve invited around to play with him. Um, I can get a bit fraught, and then I get frustrated because I expect him just to play nicely alongside our visitors and to share” (Robyn - B3).
Behavioural parenting programmes have been criticised because they do not, generally, deal with emotions and, if they do, it is only a small component of the training programme. For example, Gottman and DeClaire (1998) criticised these programmes for tending to address misbehaviour but without attending to the feelings that are underlying that misbehaviour. There needs to be more emphasis on how emotions, cognitions and action affect each other reciprocally when designing interventions aimed at preventing the emergence of behaviour problems in children (Izard, 2002).
Havighurst (2003) claimed that despite research showing an association between children’s emotional competencies and emotion coaching, parenting interventions have been slow to incorporate these features. Orbio de Castro, Koops, and Meerum Terwogt (2004) criticised that while it is acknowledged that children
with behavioural problems often struggle to interpret others emotions correctly or to appropriately manage their own emotions, scant attention is given to emotional factors in behavioural parenting programmes.
One study has indicated that childhood aggression in children in their early childhood years is linked with the affective relationship they have with their parents. This study indicated that conflict in the parent-child relationship predicted a
significant amount of variance in teacher-reported relational aggression with peers for children in early childhood (Ostrov & Bishop, 2008). This research claims, therefore that the nature of the relationship between the parent and the child, rather than only parenting practices, influences the degree of relational aggression with peers for children in this age group.
Havighurst (2003) has carried out an intervention programme for parents of children with behavioural problems that places an emphasis on increasing children’s ability to regulate emotions, express emotions, and to understand emotions and how they function. The exercises involved in the programme focus on teaching the five skills of emotion coaching that has been shown to be important for training children to manage their emotions effectively (Gottman, Katz, & Hooven, 1997). In more serious cases of child behaviour problems Katz and Windecker-Nelson (2004) found the parents of these children were less aware of their own emotions and the emotions of their children, and therefore an implicit component to any intervention programme for disruptive behaviour in children would be to focus on parent’s awareness of emotion.
Emotions are Essential
However, it is imperative for all families to learn to manage emotions as emotions are an important and essential part of being human. Denham and Burton (2003) have revealed that being emotionally competent is closely related to social competence and mental health and, as with many aspects of development, children are reliant on their parents to learn about emotions and how to manage them appropriately. Denham and Burton further state that the sort of socialisation that contributes to overall social competence in children includes warm, empathic care giving, affection, and the modelling of nurturance. This social competence comes from children’s understanding of emotions and his/her expression and regulation of emotions. These factors are, in turn, affected by parental socialisation about
modelling emotions, reactions to emotions and coaching about emotions as well as the child’s own temperament, cognitions and goals. Denham and Burton found that there was a generally positive picture for ‘emotion coaching’ that assisted children in developing these skills.
Gottman and Mettetal (1986) also support these statements as they indicate that emotional control affects the child’s growing friendships with peers, as it is critical for conflict management and for engaging in co-ordinated play. They
emphasise that involvement in cooperative play, which is an essential developmental stage for children (Piaget, 1951/1962), especially requires children to be able to control negative affect.
A primary developmental task for children in early childhood is to form friendships and to learn to engage in cooperative play with peers (Piaget,
1951/1962),whichcanrequire a lot of attention, involvement, and coordination that has the potential for solidarity but, in addition, provides an increased chance for conflict and disagreement. Unless a child is able to control negative emotions this will negatively affect the interactions with peers. Research indicates that children are attracted to children who are similar in age, sex and race and who have the same preferences for leisure activities and similar attitudes to learning (Parker, 1986). Ginsberg, Gottman, & Parker (1986) claim that there are six functions of friendship in children: companionship; stimulation; physical support; ego support/enhancement; social comparison; and intimacy/affection. In addition, they assert that it is generally important, in several dimensions of life, for children to be well accepted by their peers, and general peer interactions have a positive influence on children’s current and long-term adjustment.
Gottman (2001) warns that there are significant risks to children who do not learn to regulate their emotions, because if children are not able to succeed at these social tasks of social interactions, or are rejected by peers and can’t make friends, then they are at risk of later problems. These research findings emphasize the importance of teaching children to manage their emotions and therefore, include an emotional component in parent training programmes. A large body of research has been conducted by John Gottman and his colleagues in this field and these principles can offer another perspective to behavioural parent training.
Emotion Coaching
Gottman et al. (1997) introduced the notion of meta-emotion (emotion about emotion) which is a structured and organised set of emotions and cognition about one’s own emotions and the emotions of others. These researchers demonstrated that the quality of the parent’s marriage, parent-child interaction, and the emotional and social development of the child are linked by the development of the emotional regulation of the child.
There are a number of steps that Gottman et al. (1997) recommend are important for parents as they coach their children in managing their emotions. These include: the parent is aware of the child’s emotion; the parent sees the child’s
emotion as an opportunity for intimacy or teaching; the parent helps the child to